Karunaratne Senuri, Wu Mengliang, Yu Xinru, Kent Stephen J, Silvers Julie, Bedggood Phillip, Metha Andrew, Mueller Scott N, Selva Kevin J, Chung Amy W, Chinnery Holly R, Nguyen Bao N, Downie Laura E
Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia.
Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, Australia.
Invest Ophthalmol Vis Sci. 2025 Sep 2;66(12):23. doi: 10.1167/iovs.66.12.23.
To characterize corneal immune cell morphodynamics and nerve features, and define the in vivo immune landscape in older adults with human immunodeficiency virus (HIV) receiving antiretroviral therapy (ART), relative to healthy age-matched adults.
In this cross-sectional study, 16 HIV-positive individuals receiving ART and 15 age-matched controls underwent ocular surface examinations and functional in vivo confocal microscopy (Fun-IVCM). Time-lapsed videos were created to analyze corneal immune cells (T cells, dendritic cells [DCs], macrophages). Subclinical indicators of corneal health (sensory nerve and endothelial cell features), clinical ocular surface findings, and tear cytokines (analyzed using multiplex bead-based immunoassay) were compared between groups.
Participants comprised mostly males (HIV 71 ± 5 years; male:female 15:1; controls 67 ± 6 years; 14:1). The HIV-positive group showed less T-cell motility at the corneal whorl relative to the control group (P = 0.01), and region-dependent differences in T-cell speed (P = 0.001) and DC area (P < 0.001). The HIV-positive group showed greater central corneal nerve fiber width (P = 0.004) and larger endothelial cells (P = 0.02). Clinical findings, corneal immune cell densities, and tear cytokine profiles were similar between groups.
Among older individuals with well-controlled HIV infection and clinically-normal ocular surface health, this study identifies subclinical group differences in corneal immune cells (potentially indicative of a heightened, pro-inflammatory activation state in the peripheral cornea) and corneal endothelial cell morphology that parallel those in chronic inflammatory disease. This study demonstrates the utility of Fun-IVCM to evaluate subclinical immune cell features in systemic disease, which could inform the future identification of biomarkers in immune-related conditions.
描述角膜免疫细胞形态动力学和神经特征，并确定接受抗逆转录病毒疗法（ART）的老年人类免疫缺陷病毒（HIV）感染者相对于年龄匹配的健康成年人的体内免疫状况。
在这项横断面研究中，16名接受ART的HIV阳性个体和15名年龄匹配的对照者接受了眼表检查和功能性体内共聚焦显微镜检查（Fun-IVCM）。制作延时视频以分析角膜免疫细胞（T细胞、树突状细胞[DCs]、巨噬细胞）。比较两组之间角膜健康的亚临床指标（感觉神经和内皮细胞特征）、临床眼表检查结果和泪液细胞因子（使用基于多重微珠的免疫测定法分析）。
参与者大多为男性（HIV感染者71±5岁；男:女为15:1；对照组67±6岁；14:1）。与对照组相比，HIV阳性组在角膜涡状区域的T细胞运动性较低（P = 0.01），且T细胞速度（P = 0.001）和DC面积（P < 0.001）存在区域依赖性差异。HIV阳性组的中央角膜神经纤维宽度更大（P = 0.004），内皮细胞更大（P = 0.02）。两组之间的临床检查结果、角膜免疫细胞密度和泪液细胞因子谱相似。
在HIV感染得到良好控制且临床眼表健康正常的老年人中，本研究发现了角膜免疫细胞的亚临床组间差异（可能表明周边角膜存在增强的促炎激活状态）以及与慢性炎症性疾病相似的角膜内皮细胞形态。本研究证明了Fun-IVCM在评估全身性疾病亚临床免疫细胞特征方面的实用性，这可能为未来免疫相关疾病生物标志物的识别提供信息。
